Trailblazing Nurse Leader Champions Diversity

December 5, 2013

Barbara Nichols, a national nurse leader who broke through color barriers to become the first Black president of the American Nurses Association, likes to point out that she entered the profession in its dinosaur days—before the advent of cardio-pulmonary resuscitation, intensive care units, and pre-mixed narcotics.

It was also prehistoric in another way; Nichols became a nurse in the 1950s, when a national system of institutionalized discrimination kept minorities from entering and advancing in nursing.

In those days, many hospitals were segregated, as were many nursing schools. Those schools that weren’t often capped the number of students from racial, ethnic, and religious minority backgrounds with rigid quota systems. Few minority nurses earned baccalaureate or advanced degrees, and fewer still rose to become leaders of the profession.

But Nichols overcame those hurdles and eventually made history as the first Black nurse to hold national and state-level nursing leadership positions. Throughout her career, she has been helping others from underrepresented backgrounds enter and advance in the profession—a mission she continues at the age of 75 as director of a diversity initiative in her home state of Wisconsin.

“My whole career has been spent raising the issue of the need for racial and ethnic inclusion and looking for specific ways to involve and include more minorities in nursing,” she says. “That has been my passion.”

Born during tail end of the Great Depression and raised in Maine, Nichols was active in children’s theater and considered becoming an actor; but she ultimately decided against it because of limited professional acting roles for Blacks. Instead, she pursued a different, more “practical” dream, and became a nurse. “I was born in the late 30s, and the job market and occupations for Blacks were very limited,” she recalls. “Pragmatically, nursing was one of the fields you could go into.”

Not that it was easy. Nichols landed a highly coveted spot at Massachusetts Memorial School of Nursing in Boston, where she was one of only four Black students in her class. She went on to earn her bachelor’s degree in nursing at Case Western Reserve University, where she was one of two Black students in her class. She took a job at Boston Children’s Hospital, where she was the only Black registered nurse (RN) on staff. She then joined the U.S. Navy, where she was one of a handful of Black nurses on a staff of 150.

But life as “a speck of pepper in a shaker of salt,” as one reporter put it, never held her back; rather, it propelled her forward as a nurse leader and advocate for diversity in nursing. As a young staff nurse, she recalls, her suggestions were ignored because of her race. “Nurses would say, ‘Well, who are you to tell us what to do,’” she recalls. “That’s when I decided to get into a leadership role. It was a direct result of being ignored, and of the impression I got that my ideas weren’t worthy of consideration because I was Black.”

And lead she did. In 1970, Nichols became the first Black woman to serve as president of the Wisconsin Nurses Association. To this day, she is still the only ethnic minority to serve as the organization’s president in its more than 100 years of existence. In 1979, Nichols went on to become the first Black president of the American Nursing Association—an organization that once banned Blacks—and served for two terms. In 1983, she became the first Black woman to hold a cabinet-level position in the state of Wisconsin when she was appointed to serve as secretary of the Wisconsin Department of Regulation and Licensing. She was named a Living Legend by the American Academy of Nurses in 2010.

“I’ve been a role model who says that Blacks can achieve and can participate in meaningful ways in issues that are central to the profession,” she says.

A Long Way to Go

A lot has changed since Nichols first entered the profession. Nursing schools are no longer segregated and no longer use quotas. Employers are working harder to recruit and retain nurses of color, she adds, and more nurses from underrepresented backgrounds are seeking higher degrees.

But there’s still a ways to go before the nursing workforce reflects the increasingly diverse population it serves. The RN workforce is 75 percent White, almost 10 percent Black. and less than 5 percent Latino, according to a 2013 report by the Health Resources and Services Administration. A more diverse nursing workforce is needed to provide culturally relevant care, improve interaction and communication between providers and patients, and narrow health disparities, according to the Institute of Medicine (IOM).

After six decades in nursing, Nichols is not giving up. A visiting associate professor at the University of Wisconsin-Milwaukee College of Nursing, Nichols recently took a position as project coordinator for the Wisconsin Action Coalition to help diversify the state’s nursing workforce. Action Coalitions are the driving force of the Future of Nursing: Campaign for Action, which is backed by the Robert Wood Johnson Foundation and AARP and aims to transform the nursing profession to improve health and health care. It is grounded in an IOM report on the future of nursing released in 2010.

“Our goal is to embed, and ground, all our activities with a diversity component,” Nichols said. To do that, she and her colleagues are gathering data about the diversity of Wisconsin’s nursing workforce, partnering with interested parties, raising money to sustain efforts to diversify the profession, and analyzing ways to promote diversity through policy and practice.

She also supports the Campaign’s national efforts to implement diversity planning, recruit and retain students and faculty from underrepresented groups, and promote advanced education and leadership development among minority nurses.

“We have a big job ahead of us,” Nichols says, adding: “Prejudice is still out there.”